Appraising LaQshya's potential in measuring quality of care for mothers and newborns: a comprehensive review of India's Labor Room Quality Improvement Initiative.

BACKGROUND: Poor intrapartum care in India contributes to high maternal and newborn mortality. India's Labor Room Quality Improvement Initiative (LaQshya) launched in 2017, aims to improve intrapartum care by minimizing complications, enforcing protocols, and promoting respectful maternity care (RMC). However, limited studies pose a challenge to fully examine its potential to assess quality of maternal and newborn care. This study aims to bridge this knowledge gap and reviews LaQshya's ability to assess maternal and newborn care quality. Findings will guide modifications for enhancing LaQshya's effectiveness. METHODS: We reviewed LaQshya's ability to assess the quality of care through a two-step approach: a comprehensive descriptive analysis using document reviews to highlight program attributes, enablers, and challenges affecting LaQshya's quality assessment capability, and a comparison of its measurement parameters with the 352 quality measures outlined in the WHO Standards for Maternal and Newborn Care. Comparing LaQshya with WHO standards offers insights into how its measurement criteria align with global standards for assessing maternity and newborn care quality. RESULTS: LaQshya utilizes several proven catalysts to enhance and measure quality- institutional structures, empirical measures, external validation, certification, and performance incentives for high-quality care. The program also embodies contemporary methods like quality circles, rapid improvement cycles, ongoing facility training, and plan-do-check, and act (PDCA) strategies for sustained quality enhancement. Key drivers of LaQshya's assessment are- leadership, staff mentoring, digital infrastructure and stakeholder engagement from certified facilities. However, governance issues, understaffing, unclear directives, competency gaps, staff reluctance towards new quality improvement approaches inhibit the program, and its capacity to enhance quality of care. LaQshya addresses 76% of WHO's 352 quality measures for maternal and newborn care but lacks comprehensive assessment of crucial elements: harmful labor practices, mistreatment of mothers or newborns, childbirth support, and effective clinical leadership and supervision. CONCLUSION: LaQshya is a powerful model for evaluating quality of care, surpassing other global assessment tools. To achieve its maximum potential, we suggest strengthening district governance structures and offering tailored training programs for RMC and other new quality processes. Furthermore, expanding its quality measurement metrics to effectively assess provider accountability, patient outcomes, rights, staff supervision, and health facility leadership will increase its ability to assess quality improvements.

Identifying overlaps and disconnects between media reports and official records of nonfatal firearm injuries in Indianapolis, Indiana, 2021-2022.

OBJECTIVE: Open-source data systems, largely drawn from media sources, are commonly used by scholars due to the lack of a comprehensive national data system. It is unclear if these data provide an accurate and complete representation of firearm injuries and their context. The study objectives were to compare firearm injuries in official police records with media reports to better identify the characteristics associated with media reporting. METHODS: Firearm injuries were identified in open-source media reports and compared to nonfatal firearm injury (n = 1642) data from official police records between January 1, 2021 to December 31, 2022 in Indianapolis, Indiana. Events were matched on date, location, and event circumstances. Four multivariate, multi-level mixed effects logistic regression models were conducted to assess which survivor, event, and community characteristics were associated with media reporting. Data were analyzed 2023 - January 2024. RESULTS: Media reported 41% of nonfatal shootings in 2021 and 45% in 2022(p < 0.05), which is approximately two out of every five shootings. Shootings involving multiple survivors, children, and self-defense were more likely to be reported, whereas unintentional shootings and shootings that occurred in structurally disadvantaged communities were less likely to be reported. CONCLUSIONS: Findings suggest that relying on media reports of firearm injuries alone may misrepresent the numbers and contexts of shootings. Public health interventions that educate journalists about these important issues may be an impactful firearm violence prevention strategy. Also, it is critical to link data systems at the local level to ensure interventions are designed and evaluated using accurate data.

Is intraspecific trait differentiation in Parthenium hysterophorus a consequence of hereditary factors and/or phenotypic plasticity?

Of the various strategies adopted by an invasive plant species for expanding its niche breadth, phenotypic differentiation (either due to plasticity and/or adaptive evolution) is proven to be the most successful. Lately, we studied the persistence of substantial morpho-functional variations within the individuals of alien invasive plant, Parthenium hysterophorus in Chandigarh, India, through field surveys. Based on observed differences, the individuals were categorized into two morphotypes, PA and PB. PA had higher leaf area, leaf biomass, and chlorophyll content as compared with PB. However, PB had a higher stem circumference, stem specific density, twig dry matter content, profuse branching, bigger canopy, and better reproductive output than PA. To substantiate the persistence of intraspecific variations in P. hysterophorus and to deduce the possible genesis of these variations, we propagated both the morphotypes under experimental conditions in winter and summer. Apart from the key morpho-functional differences observed during the field studies, protein and carbohydrate metabolism were studied in leaves and roots of the propagated plants. Differences in plant metabolism were observed only during the early growth period, whereas the morpho-functional traits varied in the mature flowering plants. The effect of growth season was highly significant on all the studied morpho-functional and biochemical parameters (p ≤ 0.05). Parent morphotypes (P) and interactions between morphotypes and seasons significantly affected several growth parameters (p ≤ 0.05). The analyses revealed that the contrasting growth conditions at the time of transplantation and early growth may regulate the phenotype of P. hysterophorus. The pattern of intraspecific variations observed during the study is justified to consider morphotype PA as winter biotype and morphotype PB as summer biotype of P. hysterophorus. The study points towards the role of plasticity or a combination of genetic and environmental (G × E) factors in producing the phenotypic variability observed in the population of P. hysterophorus.

Healthcare provider perspectives on COVID-19 vaccination for children in India.

BACKGROUND: The rapid development and deployment of effective COVID-19 vaccines have been critical to halt the spread of the pandemic. India started vaccinating children in early 2022, however, vaccine uptake has been suboptimal. METHODS: Between September and November 2022, we conducted an online survey that was disseminated to eligible participants via email, text messages and social media platforms across India. The survey aimed to gather the perspectives of Indian healthcare providers regarding key factors related to the rollout of paediatric COVID-19 vaccines. Descriptive statistics were used to analyse participant demographics and responses on knowledge about paediatric COVID-19 vaccines, perceived risks and benefits, and vaccine rollout strategies. RESULTS: The survey yielded 805 respondents from 23 Indian states; 63.5% were men, 97.3% were paediatricians, median age was 44 years (IQR 25-81). Eighty-one per cent and 65.2% respondents had heard about the most common paediatric COVID-19 vaccines in India, Covaxin and Corbevax, but only 52.9%, 53.7% and 62.1% felt adequately informed about their safety, efficacy and vaccination schedules, respectively. Thirty per cent of respondents were unaware of vaccination guidelines. Eighty-five per cent of respondents felt that vaccines would reduce the incidence of severe disease, hospitalisation and deaths, and 60.6% felt children with comorbidities should be prioritised for vaccination. Perceived supply side barriers included lack of enforcement of guidelines (45.2%) and adverse effects following immunisation monitoring systems (37.6%), and on the demand side, parental vaccine hesitancy (64.4%). Eighty-one per cent believed that school-based vaccination strategies would be highly effective in increasing uptake. CONCLUSIONS: Most respondents were in support of the COVID-19 paediatric vaccination, although just over half did not feel adequately informed. Concerns about vaccine hesitancy among caregivers were the leading reported barrier. Targeted interventions are needed to provide adequate knowledge support to healthcare providers and evidence-based public health messaging to reduce vaccine hesitancy among caregivers.

Ecology, Biology, Environmental Impacts, and Management of an Agro-Environmental Weed Ageratum conyzoides.

Ageratum conyzoides L. (Billy goat weed; Asteraceae) is an annual herbaceous plant of American origin with a pantropical distribution. The plant has unique biological attributes and a raft of miscellaneous chemical compounds that render it a pharmacologically important herb. Despite its high medicinal value, the constant spread of the weed is noticeable and alarming. In many countries, the weed has severely invaded the natural, urban, and agroecosystems, thus presenting management challenges to natural resource professionals and farmers. Its interference with agricultural crops, grassland forbs, forest ground flora, and its ability to replace native plant species are of serious concern. Therefore, it is pertinent to monitor its continuous spread, its entry into new geographic regions, the extent of its impact, and the associated evolutionary changes. While management strategies should be improvised to control its spread and reduce its adverse impacts, the possible utilization of this noxious weed for pharmacological and agronomic purposes should also be explored. The objective of this review is to provide a detailed account of the global distribution, biological activities, ecological and environmental impacts, and strategies for the management of the agro-environmental weed A. conyzoides.

Modelling the ecological impact of invasive weed Verbesina encelioides on vegetation composition across dryland ecosystems of Punjab, northwestern India.

Events of climate change have led to increased aridification, which alters local vegetation patterns and results in the invasion of opportunistic species. Though many studies assess the impact of invasive weeds and aridification at the agronomic level, studies investigating changes in local vegetation are severely lacking. We investigated the impact of the invasive plant Verbesina encelioides (Asteraceae) on the local vegetation composition across different dryland ecosystems in Punjab, northwestern India. Based on the aridity index for the period of 1991-2016, three major dryland ecosystems, i.e., arid, semi-arid, and sub-humid, were found in Punjab. The impact of V. encelioides on local biodiversity was measured in terms of species diversity (using Shannon's diversity index, Simpson's dominance index, Hill's evenness index, and Margalef's richness index), species composition (using non-metric multidimensional scaling based on Bray-Curtis's dissimilarity index), and species proportion in the two invasion classes (uninvaded and invaded) and across the three aridity zones (arid, semi-arid, and sub-humid). The vegetation survey depicted the presence of 53 flowering species belonging to 22 families, including 30 exotics and 23 natives. Verbesina encelioides decreased species diversity and proportion, with a more pronounced impact in arid and semi-arid ecosystems. In contrast, species composition varied between uninvaded and invaded classes only in arid ecosystems. Ecological parameters derived from population statistics (number of individuals) were more drastically affected than those from species abundance data. Since the ecological impacts of V. encelioides were manifested with increased aridification, it is a matter of apprehension under the potential climate change scenario.

Investigating the phytotoxic potential of Verbesina encelioides: effect on growth and performance of co-occurring weed species.

Allelopathy has been proposed as an efficient mechanism of invasion by plant species via growth inhibition and suppression of the resident plant community. Verbesina encelioides (Cav.) Benth. & Hook. f. ex A. Gray (golden crownbeard; Asteraceae), a native of south-western USA and Mexican Plateau, is an emerging troublesome invasive weed species of north-western states of India. We investigated the allelopathic potential of the aqueous extracts prepared from the fresh foliage and leaf litter of V. encelioides on its co-occurring species, Amaranthus viridis and Senna occidentalis. Phytotoxicity bioassay showed concentration-dependent (control < 0.5% < 1% < 2% < 4% extract) inhibition of growth and photosynthetic parameters in the test plants. Both the extracts induced ~ 50% inhibition of germination compared to control at 4% concentration. The maximum synthesis effect (collective effect on seedling length and dry weight) was observed to be - 0.69 and - 0.62 in A. viridis and - 0.68 and - 0.57 in S. occidentalis for the fresh leaf and leaf litter extracts, respectively, at 4% concentration. Also, an antagonistic concentration-dependent impact was observed on the photosynthetic pigments (total chlorophyll and chlorophyll a content) and photosynthetic efficiency. The liquid chromatography-mass spectrometry assay of leaf extracts revealed the presence of 15 allelochemicals including phenolic acids, flavonoids, phytosterols, phytophenols, dicarboxylic acid, guanidine, and triterpenes. Of these, 14 compounds were present in both fresh and leaf litter materials. However, a guanidine derivative, galegine, was only found in the fresh leaf material of the plant. The findings support the novel weapon hypothesis and suggest that V. encelioides competitively excludes its neighboring plants by virtue of allelopathic interference.

Projected Impacts of Climate Change on the Range Expansion of the Invasive Straggler Daisy (Calyptocarpus vialis) in the Northwestern Indian Himalayan Region.

Human-induced climate change modifies plant species distribution, reorganizing ecologically suitable habitats for invasive species. In this study, we identified the environmental factors that are important for the spread of Calyptocarpus vialis, an emerging invasive weed in the northwestern Indian Himalayan Region (IHR), along with possible habitats of the weed under current climatic scenarios and potential range expansion under several representative concentration pathways (RCPs) using MaxEnt niche modeling. The prediction had a high AUC (area under the curve) value of 0.894 ± 0.010 and a remarkable correlation between the test and expected omission rates. BIO15 (precipitation seasonality; 38.8%) and BIO1 (annual mean temperature; 35.7%) had the greatest impact on the probable distribution of C. vialis, followed by elevation (11.7%) and landcover (6.3%). The findings show that, unlike the current situation, "high" and "very high" suitability areas would rise while less-suited habitats would disappear. All RCPs (2.6, 4.5, 6.0, and 8.5) indicate the expansion of C. vialis in "high" suitability areas, but RCP 4.5 predicts contraction, and RCPs 2.6, 6.0, and 8.5 predict expansion in "very high" probability areas. The current distribution of C. vialis is 21.59% of the total area of the state, with "medium" to "high" invasion suitability, but under the RCP 8.5 scenario, it might grow by 10% by 2070. The study also reveals that C. vialis may expand its niche at both lower and higher elevations. This study clarifies how bioclimatic and topographic factors affect the dispersion of invasive species in the biodiverse IHR. Policymakers and land-use managers can utilize the data to monitor C. vialis hotspots and develop scientifically sound management methods.

Is perinatal asphyxia associated with an increase in serum bilirubin in neonates? A case-control study.

Objective: Perinatal asphyxia affects different organs of body depending upon the severity of hypoxemia and ischemia. This study was carried out to evaluate severity of hyperbilirubinemia in relation to severity of asphyxia. Study Design: A case-control study. Methodology: Asphyxiated newborns with Apgar score ≤7 at 1 min. and categorized as severe birth asphyxia according to the WHO classification of diseases (ICD10) were matched with controls without birth asphyxia. All babies were examined twice daily for dermal icterus until start of phototherapy. Babies with congenital heart disease, sepsis, cephalohematoma, blood group incompatibility were excluded. Arterial blood gas analysis was done along with serial TSB measurement as per standard guidelines. Results: 50 cases and 50 matched controls were enrolled. The average birth weight and gestation in cases was 2427 ± 30.05 g and 35.9 ± 2.5 weeks and among control it was 2633 ± 378.62 g and 37.76 ± 0.116 weeks. Among cases, onset of jaundice was 56.64 ± 20.43 h compared to 63.36 ± 23 h in control group. In the cases, the average pH was 7.31 ± 0.06, CO2 was 41.52 ± 84, O2 was 94.98 ± 14.83, and HCO3 was 18.56 ± 2.04. The rise and peak of serum bilirubin differed between the case and control groups; in the cases, the peak occurred at the 22nd h of life, then plateaued from the 40th to the 78th hour of life, and ultimately fell at the 96th hour of life. In comparison, the rise and peak of serum bilirubin occurred comparatively late in the control group. The rise and peak in the control group occurred at the 80th and 96th h of life, respectively. The multiple linear regression analysis showed CRP, Apgar at 5 min. below 7 and male gender significantly affects the rise of serum bilirubin (P < 0.05). Conclusion: The peak serum bilirubin in asphyxiated newborns occurs earlier, and plateau for longer duration compared to normal newborns. Low Apgar at 5 min. has significant correlation to earlier rise of bilirubin.

Correlation of Vitamin D Deficiency with Predictors of Mortality in Critically Ill Children at a Tertiary Care Centre in North India-A Prospective, Observational Study.

This study was conducted to assess the relationship of vitamin D deficiency (VDD) with various demographic characteristics, laboratory parameters, and predictors of mortality. This prospective observational study was performed at pediatric intensive care unit (PICU) of a tertiary care hospital situated in north India. A total of 125 children admitted in PICU with age from 2 months to 14 years were analyzed. The subjects were classified as Vitamin D deficient (≤20 ng/mL) and nondeficient (>20 ng/mL). The relationship between VDD and predictors of mortality were analyzed using correlation and multivariate analysis. Respiratory system (40%) was most commonly involved. VDD was seen in 72% of the patients. There was statistically significant correlation of VDD with age ( p = 0.019), season ( p = 0.018), height ( p = 0.005), and weight ( p = 0.003). On multivariate analysis factors associated with VDD were age (odds ratio [OR] = 1.01, 95% confidence interval [CI] 1.00-1.03, p = 0.006), season (OR = 3.98, 95% CI 1.09-14.50, p = 0.036). VDD was also correlated to bacteriuria ( p = 0.033), cardiovascular sequential sepsis-related organ failure assessment score (CV-SOFA score) ( p = 0.001), and mechanical ventilation ( p = 0.043). On multivariate analysis, factors associated with VDD were bacteriuria (OR = 4.88, 95% CI 1.04-22.89, p = 0.04), mechanical ventilation requirement (OR = 2.95, 95% CI 1.12-7.85, p = 0.029), and CV-SOFA score (OR = 2.33, 95% CI 1.14-4.76, p = 0.021). Median (interquartile range) duration of PICU stay in VDD patients was (3-7) days while in nondeficient patients it was (2-6) days ( p = 0.107). VDD was a significant risk factor for the need of mechanical ventilation, bacteriuria, and mortality among patients in our cohort.

Quality Improvement Initiative to Improve Hand Hygiene Compliance in Indian Special Newborn Care Unit.

Pilot data on Hand hygiene (HH) compliance using a standard World Health Organisation checklist for 1-week suggested only 20% compliance. So, we planned a Quality Improvement study to improve HH compliance among health care providers in our Special Newborn Care Unit from 20% to 60% over 12 months. METHODS: We did this study in 3 phases: Baseline phase (2 months), Intervention phase (8 months), and Postintervention phase (2 months). A multidisciplinary Quality Improvement team composed of doctors, nursing staff, and ward attendants was constituted. The team analyzed potential barriers to HH by Fishbone analysis. Three trained observers randomly selected two target Special Newborn Care Unit patients daily and collected data on HH compliance unobtrusively during the three 8-h shifts over 24 h. In addition, we tested a range of interventions using multiple Plan Do Study Act cycles: Staff education; Displaying posters; Round the clock availability of soap and hand rub; Staff felicitation; Group performance feedback. We also collected data on healthcare-associated infections in all three phases. RESULTS: The total observations for HH during the baseline, intervention, and postintervention phase were 1488, 5808, and 1464, respectively. The HH compliance improved from 27.2% to 57.1% in the postintervention phase. There was no difference in the healthcare-associated infections among the three phases. CONCLUSIONS: The HH compliance rates improved significantly but not to the desired extent. So, we planned to increase our workforce, and improve our training program and infrastructure.

Parthenin-A Sesquiterpene Lactone with Multifaceted Biological Activities: Insights and Prospects.

Parthenin, a sesquiterpene lactone of pseudoguaianolide type, is the representative secondary metabolite of the tropical weed Parthenium hysterophorus (Asteraceae). It accounts for a multitude of biological activities, including toxicity, allergenicity, allelopathy, and pharmacological aspects of the plant. Thus far, parthenin and its derivatives have been tested for chemotherapeutic abilities, medicinal properties, and herbicidal/pesticidal activities. However, due to the lack of toxicity-bioactivity relationship studies, the versatile properties of parthenin are relatively less utilised. The possibility of exploiting parthenin in different scientific fields (e.g., chemistry, medicine, and agriculture) makes it a subject of analytical discussion. The present review highlights the multifaceted uses of parthenin, on-going research, constraints in the practical applicability, and the possible workarounds for its successful utilisation. The main aim of this comprehensive discussion is to bring parthenin to the attention of researchers, pharmacologists, natural product chemists, and chemical biologists and to open the door for its multidimensional applications.

An Overview of the Characteristics and Potential of Calotropis procera From Botanical, Ecological, and Economic Perspectives.

Calotropis procera (Aiton) Dryand. (commonly known as the apple of sodom, calotrope, and giant milkweed) is an evergreen, perennial shrub of the family Apocynaceae, mainly found in arid and semi-arid regions. It is a multipurpose plant, which can be utilized for medicine, fodder, and fuel purposes, timber and fiber production, phytoremediation, and synthesis of nanoparticles. It has been widely used in traditional medicinal systems across North Africa, Middle East Asia, and South-East Asia. At present, it is being extensively explored for its potential pharmacological applications. Several reports also suggest its prospects in the food, textile, and paper industries. Besides, C. procera has also been acknowledged as an ornamental species. High pharmacological potential and socio-economic value have led to the pantropical introduction of the plant. Morpho-physiological adaptations and the ability to tolerate various abiotic stresses enabled its naturalization beyond the introduced areas. Now, it is recognized as an obnoxious environmental weed in several parts of the world. Its unnatural expansion has been witnessed in the regions of South America, the Caribbean Islands, Australia, the Hawaiian Islands, Mexico, Seychelles, and several Pacific Islands. In Australia, nearly 3.7 million hectares of drier areas, including rangelands and Savannahs, have been invaded by the plant. In this review, multiple aspects of C. procera have been discussed including its general characteristics, current and potential uses, and invasive tendencies. The objectives of this review are a) to compile the information available in the literature on C. procera, to make it accessible for future research, b) to enlist together its potential applications being investigated in different fields, and c) to acknowledge C. procera as an emerging invasive species of arid and semi-arid regions.

Association of Vitamin D with Thyroid Status in a Tertiary Care Hospital in North India.

BACKGROUND: Vitamin D acts as immunomodulatory molecule and its deficiency has been implicated in various autoimmune diseases including immune mediated hypothyroidism. However, its association with thyroid hormones is ambiguous. The present study was therefore aimed to explore the relationship of vitamin D with thyroid hormone levels in a population enrolled for health care check up in a tertiary care hospital. METHODS: The present cross-sectional study included 664 subjects. Serum levels of 25(OH) vitamin D, free triiodothyronine, free thyroxine, and thyroid stimulating hormone (TSH) were measured. Serum vitamin 25(OH)D levels < 30 ng/mL and > 30 ng/mL were considered as vitamin D insufficient and vitamin D sufficient state, respectively. RESULTS: Vitamin D insufficiency was greater in females (89.6%) than in males (78.5%). Females were observed to have significantly lower serum 25(OH)D levels (18.7 ± 9.5 versus 20.62 ± 10.2 ng/mL) and higher serum TSH values (2.5 ± 1.25 versus 2.25 ± 1.16 mIU/L) as compared to males. The serum TSH level in the vitamin D sufficiency group were significantly lower than those in the vitamin D insufficiency group (2.39 ± 1.22 versus 2.12 ± 1.1 mIU/ L). Further, age was the only significant predictor of TSH levels. Meanwhile, no predictor was identified for vitamin D levels. CONCLUSIONS: Although no association was observed between TSH and vitamin D levels, TSH was observed to be significantly higher in the vitamin D insufficient group than the vitamin D sufficient group. It warrants further studies to ascertain the role of vitamin D in regulating thyroid hormones considering the thyroid autoimmune status of the individuals as well.

Nature of phytotoxic interference of alien weed 'Calyptocarpus vialis' against some crop plants.

Calyptocarpus vialis (syn. Synedrella vialis; Asteraceae), a native of the tropical Americas, has acquired an invasive status in the eastern Asia and Africa and, of late, in India. It is an annual herbaceous weed that forms a dominant ground cover due to its prostrate expansion and interferes with the growth of other plant species. However, the reasons for this interference are largely unknown. Therefore, we examined the allelopathic interference of C. vialis via leachation and residue degradation on the emergence, growth, and development of three crop species (Brassica nigra, Triticum aestivum, and Avena sativa). In a laboratory bioassay, the leachates (0.5-4%) of C. vialis exhibited a dose-dependent inhibitory effect on various growth parameters of the test plants. Similarly, under screenhouse, C. vialis-amended soil (1-4%) affected the growth of test species in a dose-dependent manner. Further, the phytotoxicity of the residues of C. vialis was examined using rhizospheric soil (RS) and residue-amended soil (RAS). It was observed that RAS exerted the maximum allelopathic effect on the test species accompanied by significant changes in pH, electrical conductivity, and total water-soluble phenolic content, as compared with the control soil (CS) and RS. Liquid chromatography and mass spectroscopy analyses confirmed the presence of eleven allelochemicals as the major phytotoxins. The study demonstrated that C. vialis exerts strong phytotoxic effects on other plants through the release of potent allelochemicals, both via leachation and residue degradation.

The implications of the gender-based prohibitions relating to human germline genome editing in the Human Fertilisation and Embryology Act.

RESEARCH QUESTION: What are the implications of the gender-based prohibitions relating to human germline genome editing (hGGE) in the Human Fertilisation and Embryology (HFE) Act 1990, as amended in 2008? DESIGN: A three-phase primary research design consisting of a mixed-methods online public survey of 521 UK citizens aged 16-82 years, 13 semi-structured interviews with experts and professionals involved in the future of hGGE, and structured interviews with 21 people affected by genetic conditions. The research was conducted between March 2018 and October 2019. RESULTS: Gender-based prohibitions in the HFE Act weaken its intent to prevent germline cells that have been altered from resulting in a pregnancy and the possible birth of people with edited genomes. This weakness could become increasingly problematic as genome editing technologies develop and social advances seek to eradicate gendered expectations and gendered binaries. CONCLUSION: The HFE Act should be amended to avoid gender-based discrimination and the potential gender-based prohibitions have to circumvent germline genome editing being used before the technology is considered safe enough to prevent disease.

Childhood sexual abuse perceptions and experience among college students of Panchkula.

BACKGROUND AND OBJECTIVE: Child sexual abuse (CSA) is a global public health and human rights concern. Hence, the present study was conducted to assess childhood sexual abuse perception and experience among college students of Panchkula. METHODOLOGY: A self-administered anonymous questionnaire which assessed perception and experiences of childhood sexual abuse was given to a convenient sample of 1000 college students. Using descriptive statistics and Chi-square test, perception and the experience of childhood sexual abuse were calculated. RESULTS: The study showed that 18% (boys = 20%, girls = 16%) of the students were exposed to CSA, with boys more often affected than girls. The student's perception about abuse was not very clear. Myths and cultural beliefs justified abuse. CONCLUSION: Although preliminary in nature, the present findings are among the first to demonstrate the nature of CSA among students of Panchkula. Further, the study revealed that CSA manifests both as contact and noncontact forms. More boys than girls are exposed to most forms of abuse.

Pediatric Risk of Mortality III Score - Predictor of Mortality and Hospital Stay in Pediatric Intensive Care Unit.

BACKGROUND: Pediatric Risk of Mortality (PRISM) III score is one of the widely used scoring systems to quantify critical illness in the pediatric age group. This study was carried out to find the association of PRISM III score with the outcome (discharge/mortality) and also hospital stay in survivors and nonsurvivors. SETTING: The study was conducted in a tertiary care hospital from January 2014 to June 2015. MATERIALS AND METHODS: A total of 524 patients were admitted, and after excluding the patients who met the exclusion criteria, 486 patients were analyzed. STATISTICAL ANALYSIS: Logistic regression was used to find the association of variables under the PRISM III score with mortality. Linear regression was used to find the association of PRISM III score with length of stay. RESULTS: Mortality was 31%; male: female ratio was 1.5:1. Maximum patients presented with respiratory system involvement (26.3%), and maximum mortality (20.3%) was observed in the patients with respiratory involvement. Discrimination by the model between mortality and survival was excellent (receiver operating characteristic curve [0.903]). Maximum risk of mortality was noticed in mechanically ventilated patients (odds ratio [OR]: 10.87) followed by lower systolic blood pressure (OR: 2.72), deranged prothrombin time, partial thromboplastin time (OR: 1.50), deranged mental status (OR: 1.41), and tachycardia (OR: 1.37). Length of stay (LOS) in patients increased till PRISM III score of 25. Average LOS in survivors was 4.327 days which was not accounted by difference in PRISM III score between different patients. With each unit increase in PRISM III score, LOS increased by 5 h. CONCLUSIONS: PRISM III score has excellent capacity to discriminate between survival and mortality. PRISM III score can be used to predict LOS among survivors.

Neonatal Intraventricular Hemorrhage and Hospitalization in Childhood.

BACKGROUND: Intraventricular hemorrhage is a serious neonatal complication associated with neurodevelopmental disorders, but the relationship with other childhood morbidities is unclear. We sought to assess the association of neonatal intraventricular hemorrhage with the risk of morbidity up to 12 years of age. METHODS: We analyzed a cohort of 794,384 infants born between 2006 and 2016 in Quebec, Canada, with 4,269,579 person-years of follow-up. The exposure was grade I to IV intraventricular hemorrhage in the neonatal period. The main outcome measure was childhood hospitalization by cause of admission. In adjusted Cox regression models, we estimated hazard ratios and 95% confidence intervals for the association of intraventricular hemorrhage with future childhood hospitalization. RESULTS: Infants with intraventricular hemorrhage had a higher incidence of childhood hospitalization than infants without hemorrhage (23.8 vs. 5.7 per 100 person-years). Compared with those with no hemorrhage, infants with intraventricular hemorrhage had 1.56 times the risk of hospitalization (95% confidence interval, 1.43-1.70). The risk was 2.81 times higher for grade III/IV hemorrhage (95% confidence interval, 2.23-3.53). Intraventricular hemorrhage at term was associated with 3.19 times the risk of hospitalization (95% confidence interval, 2.55-4.00), whereas preterm intraventricular hemorrhage was associated with 2.06 times the risk before 28 weeks (95% confidence interval, 1.75-2.42) and 1.87 times the risk between 28 and 36 weeks (95% confidence interval, 1.68-2.08), compared with no hemorrhage at term. Primary reasons for hospitalizations included central nervous system, ophthalmologic, musculoskeletal, and cardiovascular disorders. CONCLUSIONS: Intraventricular hemorrhage, especially of higher grades and in term neonates, is a predictor of future risk of hospitalization in childhood.

Phenotypic variations alter the ecological impact of invasive alien species: Lessons from Parthenium hysterophorus.

Invasive plant species constantly adjust their behavior with ecological shifts by virtue of phenotypic plasticity and/or local adaptations. Changes in the phenotype of an invasive species may also trigger variations in its community level impacts, which is an acceptable, yet unexplored aspect of invasion biology. Our study attempts to fill important knowledge gaps on the basic behavior and ecological interactions of invasive species. Parthenium hysterophorus, a widely distributed invasive alien species of tropical and sub-tropical regions, was evaluated for variations in its morpho-functional traits and ecological performance at a common spatial and temporal scale. Field surveys were conducted in Chandigarh, India, in five sites identified as invaded with P. hysterophorus. Individuals of P. hysterophorus randomly sampled from these sites, showed from trait analyses that the population is differentiated into two morphotypes, PA and PB. Morphotype PB exhibits traits comparable to the shrub life-form in terms of woody stem (with higher stem circumference [+32.26%], stem specific density [+128.57%], twig dry matter content [+25.15%]); profuse branching (+46.38%); larger canopy (+91.16%); and better reproductive output (+190.29%) compared to PA. PA, on the other hand, reflected herbaceous characteristics with greater leaf area (+67.58%) and higher content of chlorophyll (+21.92%) compared to PB. Based on these morphotypes, the plots were divided into three invasion categories: areas invaded by PA [IPA], areas invaded by PB [IPB] and uninvaded areas [UI]. Ecological indices and soil chemical properties were compared across IPA, IPB and UI. Shannon's index (p < 0.001), evenness index (p = 0.008), and richness index (p < 0.001) were significantly lower in IPB compared to IPA. UI areas were found to have higher soil pH, phenolics, organic matter, and concentrations of N, P and K, compared to IPA and IPB, but lower Ca and Mg. Results suggest that phenotypic variations within population of P. hysterophorus regulate its ecological impact on associated vegetation. Conservation managers would benefit from studying its invasion patterns and identifying the morphotype with higher ecological impact to prioritize management efforts. Monitoring these behavioral and ecological patterns in P. hysterophorus over the long-term may also help in anticipating challenges to preventive measures.